A 28-year-old woman had a levonorgestrel intrauterine system (LNG-IUS, Mirena) inserted 6 weeks ago. She attends the GP reporting irregular bleeding a...

Question

A 28-year-old woman had a levonorgestrel intrauterine system (LNG-IUS, Mirena) inserted 6 weeks ago. She attends the GP reporting irregular bleeding and spotting since insertion. She is otherwise well and has no pain or abnormal discharge. Which is the single most appropriate management?

Accepted Answer

Reassure that irregular bleeding is common in the first 3-6 months and review if it persists

Answer

Remove the LNG-IUS and offer an alternative method

Answer

Arrange a pelvic ultrasound to check IUS position

Answer

Prescribe a short course of combined oral contraceptive pill to control the bleeding

Answer

Take endocervical swabs to exclude infection

uk-drcog MCQ (SBA): LNG-IUS Side Effects

A 28-year-old woman had a levonorgestrel intrauterine system (LNG-IUS, Mirena) inserted 6 weeks ago. She attends the GP reporting irregular bleeding and spotting since insertion. She is otherwise well and has no pain or abnormal discharge. Which is the single most appropriate management?